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短疗程博纳吐单抗治疗作为复发/难治性B细胞急性淋巴细胞白血病进一步挽救治疗的桥梁:一项回顾性单中心研究

Short-Course Blinatumomab Treatment as a Bridge to Further Salvage Therapy for Relapsed/Refractory B-Cell Acute Lymphoblastic Leukemia: A Retrospective Single-Center Study.

作者信息

Yin Jin, Cai Xiaoya, Qian Bingxin, Liu Ying, Li Dengju

机构信息

Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Cancer Med. 2024 Dec;13(24):e70515. doi: 10.1002/cam4.70515.

DOI:10.1002/cam4.70515
PMID:39692275
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11653214/
Abstract

BACKGROUD

The high cost of blinatumomab in full doses of full treatments has led to dose reduction and fewer treatment cycles for most patients in China. With current needs for cost-efficiency and resource management in health care, we retrospectively evaluated the clinical effects of short-course blinatumomab treatment for R/R Ph- B-ALL at our center.

METHODS

Blinatumomab was administered with 24-h continuous intravenous infusion (9 μg/day for the first 3 days and 28 μg/day for 6-10 days). The clinical data of 30 R/R B-ALL patients were collected and analyzed.

RESULTS

A total of 25 patients (83.3%) including 13 (43.3%) with a high leukemic load (> 50%) achieved morphological CR. Twelve patients (40%) were MRD-negative. The estimated 2-year OS rate was 82.62%. The 2-year PFS rate was 78.35%. The estimated 2-year OS and PFS were significantly better in patients receiving further treatment.

CONCLUSIONS

Our findings provide novel insights into the optimization of blinatumomab therapy, proposing a viable treatment alternative that aligns with current needs for cost-efficiency and resource management in health care.

摘要

背景

在中国,全剂量全程使用博纳吐单抗的高昂费用导致大多数患者减少剂量并缩短治疗周期。鉴于当前医疗保健中对成本效益和资源管理的需求,我们回顾性评估了我院短疗程博纳吐单抗治疗复发/难治性Ph- B-ALL的临床效果。

方法

博纳吐单抗采用24小时持续静脉输注给药(前3天为9μg/天,第6 - 10天为28μg/天)。收集并分析30例复发/难治性B-ALL患者的临床资料。

结果

共有25例患者(83.3%)达到形态学完全缓解,其中13例(43.3%)白血病负荷高(>50%)。12例患者(40%)微小残留病呈阴性。估计2年总生存率为82.62%。2年无进展生存率为78.35%。接受进一步治疗的患者估计2年总生存率和无进展生存率显著更高。

结论

我们的研究结果为博纳吐单抗治疗的优化提供了新见解,提出了一种可行的治疗方案,符合当前医疗保健中对成本效益和资源管理的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3642/11653214/d2967d1f5449/CAM4-13-e70515-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3642/11653214/62eeb4c19b24/CAM4-13-e70515-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3642/11653214/d2967d1f5449/CAM4-13-e70515-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3642/11653214/62eeb4c19b24/CAM4-13-e70515-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3642/11653214/d2967d1f5449/CAM4-13-e70515-g001.jpg

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本文引用的文献

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Management of ALL in adults: 2024 ELN recommendations from a European expert panel.成人 ALL 的治疗管理:来自欧洲专家小组的 2024ELN 建议。
Blood. 2024 May 9;143(19):1903-1930. doi: 10.1182/blood.2023023568.
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Superior survival outcome of blinatumomab compared with conventional chemotherapy for adult patients with relapsed or refractory B-cell precursor acute lymphoblastic leukemia: a propensity score-matched cohort analysis.与传统化疗相比,博纳吐单抗治疗复发或难治性B细胞前体急性淋巴细胞白血病成年患者的生存结局更佳:一项倾向评分匹配队列分析。
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PD-1 Inhibition Enhances Blinatumomab Response in a UCB/PDX Model of Relapsed Pediatric B-Cell Acute Lymphoblastic Leukemia.
在复发性儿童B细胞急性淋巴细胞白血病的脐血/人源化小鼠模型中,程序性死亡受体1(PD-1)抑制增强了博纳吐单抗的疗效。
Front Oncol. 2021 Apr 13;11:642466. doi: 10.3389/fonc.2021.642466. eCollection 2021.
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Feasible outcome of blinatumomab followed by allogeneic hematopoietic cell transplantation for adults with Philadelphia chromosome-negative acute lymphoblastic leukemia in first salvage.费城染色体阴性的成人急性淋巴细胞白血病一线挽救后接受blinatumomab 序贯异基因造血干细胞移植的可行性结果。
Cancer Med. 2019 Dec;8(18):7650-7659. doi: 10.1002/cam4.2680. Epub 2019 Nov 5.
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Blood. 2019 Apr 4;133(14):1548-1559. doi: 10.1182/blood-2018-10-881961. Epub 2019 Jan 18.
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Efficacy and safety of blinatumomab treatment in adult Korean patients with relapsed/refractory acute lymphoblastic leukemia on behalf of the Korean Society of Hematology ALL Working Party.以韩国血液学会 ALL 工作组代表的身份,评估blinatumomab 治疗复发/难治性成人急性淋巴细胞白血病的疗效和安全性。
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